Lale Umutlu MD, Presenter: Consultant, Bayer AG

Anja Fischer MD, Abstract Co-Author: Nothing to Disclose

Cornelius Deuschl, Abstract Co-Author: Nothing to Disclose

Jorg Hense, Abstract Co-Author: Nothing to Disclose

Thomas C. Lauenstein MD, Abstract Co-Author: Nothing to Disclose

Michael Forsting MD, Abstract Co-Author: Nothing to Disclose

Mark E. Ladd PhD, Abstract Co-Author: Nothing to Disclose

Oliver Kraff MSc, Abstract Co-Author: Nothing to Disclose

Marc U. Schlamann, Abstract Co-Author: Nothing to Disclose

Glioblastoma multiforme is known to be the most common and most aggressive malignant primary brain tumor in humans. Pretreatment assessment of exact localization, tumor extent and tumor-associated vasculature is inevitable. With successful introduction of ultra-high-field brain MRI within the last few years and potential benefits associated to the increase of the field strength, the aim of this trial was to compare the diagnostic ability of tumor assessment utilizing 3T and 7T magnetic field strength.

10 subjects were examined on a 3T MR scanner (Magnetom Skyra) and a 7T whole-body MR system (Magnetom 7T; both Siemens Healthcare) utilizing 32-channel head coils (Siemens Healthcare). Inter-field strength comparisons were performed for the following sequences: (1) SWI imaging (3T voxel size = 0.7x0.8x2.6 mm3; 7 Tesla voxel size = 0.25x0.25x1.0 mm3), (2) T2w FLAIR sequence (3T voxel size = 0.4x0.4x5.0 mm3 ; 7T voxel size = 0.6x0.6x5.0 mm3) and (3) a post-contrast T1-w 3D MPRAGE (3T voxel size = 0.5x1.0x1.0 mm3; 7 Tesla voxel size 0.7x 0.7x 0.7mm3). Two radiologists assessed the delineation of the (1) tumor in T1w MRI, (2) microvasculature in SWI imaging, (3) potential necrosis and edema in FLAIR imaging, (4) overall image quality for all squences and (5) impairment due to artifacts utilizing a 5-point scale (5= excellent to 1= non-diagnostic).

Visual analysis revealed an equivalently high delineation of tumor extent and morphology as well as tumor-associated edema at both field strengths (MPRAGE 3T 4.7 vs MPRAGE 7T 4.9; FLAIR3T 4.6 vs Flair7T 4.6). 7T SWI MRI demonstrated its superiority, yielding a significant improvement in the assessment of tumor-associated microvasculature (SWI 3T 3.8 vs SWI 7T 4.8). Evaluation of artifacts showed slightly stronger image impairment for 7T imaging (mean3T 4.7 vs mean7T 4.3).

Both field strengths provide high-quality assessment of tumor extent, morphology and tumor-associated edema / necrosis, with 7T SWI imaging demonstrating its superiority in the assessment of tumor-associated microvasculature, in terms of tumor-associated neoangiogenesis.

7 Tesla enables superior assessment of tumor-associated neoangionesis, potentially allowing for superior therapy monitoring of patients undergoing anti-angiogenic therapy.

Umutlu, L, Fischer, A, Deuschl, C, Hense, J, Lauenstein, T, Forsting, M, Ladd, M, Kraff, O, Schlamann, M, Imaging Glioblastoma Multiforme at 7T versus 3T: The More Tesla, the Better?.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14013714.html